Peer-reviewed article
Men care too: a qualitative study examining women’s perceptions of fathers’ engagement in early childhood development (ECD) during an ECD program for HIV-positive mothers in Malawi
Tijana Temelkovska, Pericles Kalande, Evelyn Udedi, Laurie Bruns, Siyenunu Mulungu et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This qualitative study explored mothers' perceptions of fathers' engagement with an integrated early childhood development and HIV prevention program in Malawi. Almost all mothers shared the program information with their partners, and most reported that fathers valued early childhood development and practiced it at home. However, fathers were reluctant to attend clinic visits due to HIV stigma, time constraints, and the perception that the program was designed for women. The study suggests that engaging fathers requires different delivery approaches, such as community outreach or programs at facilities fathers already use.
Key points
- 29 mothers reported that almost all discussed the PMTCT-ECD intervention with male partners
- Most fathers viewed early childhood development as valuable and practised ECD activities at home
- Several mothers reported improved partner relationships and increased communication as a result of the intervention
- Most mothers believed fathers would not attend clinic-based sessions due to HIV stigma, time constraints, and perception the program was for women
- Fathers were interested in ECD content but uncomfortable visiting PMTCT clinics
Limitations
This study captures only mothers' perceptions of fathers' views and engagement; fathers' own perspectives were not directly elicited. The findings are limited to four health facilities in Malawi and cannot be generalized beyond this setting.
Abstract
OBJECTIVES: Integrated early childhood development (ECD) and prevention of mother-to-child transmission (PMTCT) interventions rarely target fathers, a missed opportunity given existing research demonstrating that father involvement improves maternal and child outcomes. We aimed to explore mother's perceptions of fathers' buy-in to an integrated PMTCT-ECD programme, any impact the programme had on couple dynamics, and perceived barriers to fathers' involvement in ECD activities. DESIGN: Qualitative study using individual in-depth interviews with mothers participating in a PMTCT-ECD programme. Interviews assessed mothers' perceptions of father buy-in and engagement in the programme and ECD activities. Data were coded using inductive and deductive strategies and analysed using constant comparison methods in Atlas.ti V.1.6. SETTING: Four health facilities in Malawi where PMTCT services were provided. PARTICIPANTS: Study participants were mothers infected with HIV who were enrolled in the PMTCT-ECD programme for >6 months. INTERVENTIONS: The PMTCT-ECD intervention provided ECD education and counselling sessions during routine PMTCT visits for mothers infected with HIV and their infants (infant age 1.5-24 months). The intervention did not target fathers, but mothers were encouraged to share information with them. RESULTS: Interviews were conducted with 29 mothers. Almost all mothers discussed the PMTCT-ECD intervention with male partners. Most mothers reported that fathers viewed ECD as valuable and practised ECD activities at home. Several reported improved partner relationships and increased communication due to the intervention. However, most mothers believed fathers would not attend the PMTCT-ECD intervention due to concerns regarding HIV-related stigma at PMTCT clinics, time required to attend and perceptions that the intervention was intended for women. CONCLUSIONS: Fathers were interested in an integrated PMTCT-ECD programme and actively practised ECD activities at home, but felt uncomfortable visiting PMTCT clinics. Interventions should consider direct community outreach or implementing ECD programmes at facility entry points where men frequent, such as outpatient departments.
Findings the Hub has extracted
Each claim below is labelled by its type of design and links back to this report.
- Intervention
- Integrated PMTCT-ECD program providing education and counselling sessions during routine PMTCT visits for HIV-positive mothers and infants (aged 1.5-24 months), with mothers encouraged to share information with fathers but no direct father targeting
- Population
- HIV-positive mothers and their infants (aged 1.5-24 months) enrolled in the program for over 6 months at four health facilities in Malawi
Key finding
Almost all mothers (29/29) discussed the intervention with male partners
Temelkovska et al. · Prof. Linda Richter (OpenAlex works) · 1 Jul 2022